Provider Demographics
NPI:1487080438
Name:DESPIEGELAERE, SHERYL LEE (NP-C)
Entity type:Individual
Prefix:MRS
First Name:SHERYL
Middle Name:LEE
Last Name:DESPIEGELAERE
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5444 S GREEN ST
Mailing Address - Street 2:
Mailing Address - City:MURRAY
Mailing Address - State:UT
Mailing Address - Zip Code:84123-5632
Mailing Address - Country:US
Mailing Address - Phone:801-313-4140
Mailing Address - Fax:
Practice Address - Street 1:3903 HARRISON BLVD STE 100
Practice Address - Street 2:
Practice Address - City:OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84403-2361
Practice Address - Country:US
Practice Address - Phone:801-387-8900
Practice Address - Fax:801-387-8920
Is Sole Proprietor?:No
Enumeration Date:2013-09-23
Last Update Date:2019-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT8546547-4405363L00000X
TX8546547-4405363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner